Exercise and cancer treatment: what to know

Updated January 2025 | 6 min read
Expert contributors Associate Professor Judith Lacey, Head of Supportive Care and Integrated Oncology at Chris O’Brien Lifehouse; Dr Shelley Kay, senior exercise physiologist
Words by Alana Wulff

Exercise was once thought to be too hard on the body during cancer treatment, but there’s now more evidence to show the link between working out and cancer recovery.

When Pauline, a Sydney-based mother of four, was diagnosed with breast cancer in 2023, she was encouraged to pursue a healthy diet and exercise while undergoing her treatment. It was a surprise, she admits.

“We were told how essential exercise was, no matter what type of treatment we were having,” she says. “I was shocked at first, but I did a lot of walking and also focused on being positive during my treatment, especially when things got difficult, as I truly believe a healthy mind creates a healthy body.”

Pauline’s experience isn’t uncommon. While we know exercise is important for general health and wellbeing, it’s also important for maintaining the mental, emotional and physical health of cancer patients.

Exercise and cancer patients

While it might not always be what cancer patients feel like doing, research suggests exercise isn’t just safe for those living with cancer or undergoing treatment – it can be beneficial.

Studies have shown that doing moderate-intensity exercise may lead to fewer and less severe treatment-related side effects, and patients will be less likely to develop other chronic diseases as a result of their cancer. In some cases, including exercise in a treatment plan may lower the chances of cancer recurrence. 

Shelley Kay, a senior exercise physiologist specialising in cancer patient recovery, believes
this simple yet powerful and non-invasive approach can be a complementary element to treatment that’s changing lives.

“It’s not just hope,” she says. “This is based on growing evidence that exercise is influencing cancer cells [positively] and this could help the treatment work better.”  

However, it isn’t possible to talk about cancer as one condition, says Associate Professor Judith Lacey, Director of Supportive Care and Integrated Oncology at Chris O’Brien Lifehouse. There are over 200 known types of cancer.

“Cancer isn’t just one disease – it’s multiple diseases, and we know that every person will have a different cancer type, which determines what treatment they’re going to receive,” she says.

While some patients may go through chemotherapy, immunotherapy and targeted therapies after a surgery, others may receive these treatments as neoadjuvant therapy (where treatment is provided first and surgery follows once the cancer cells have been reduced).

“Increasingly we’re realising we need to support people with personalised exercise plans starting from the time of diagnosis as this can positively impact their wellbeing and potentially their long-term survival, tolerance of treatment and response to treatment,” she adds.

So far, most research has focused on the role of exercise for breast, colorectal and prostate cancer patients. While experts agree more research is needed to understand the role of exercise in every cancer and in every stage of that cancer, research shows regular exercise is beneficial in areas related to undergoing cancer treatment, including maintaining muscle mass, reducing cancer-related fatigue, improving brain function, reducing pain and enhancing sexual wellbeing.

To locate an oncology specialist, HCF members can use the Find a Provider tool to find a specialist in our network to reduce out-of-pocket costs. If you've been diagnosed with a medical condition like cancer, eligible members^* can get a free, confidential second opinion on a health condition from a certified, practising medical specialist based in Australia.   

You may also be able to claim towards the cost of a gym membership or exercise classes, if prescribed by a GP.  

What type of exercise is most beneficial?

While the assumption might be that low-impact exercises might be best for patients after treatment, active workouts and weight training have been shown to be more beneficial, says Dr Kay.

“The evidence shows that moderate to high intensity is more [effective], particularly for cancer-related fatigue,” says Dr Kay. “It’s more important to find the right intervention for each individual at different times along the treatment trajectory. This is how exercise is used as medicine, the exercise dose needs to be matched to the person’s condition.”

Since 2018 and the release of guidelines developed by the Clinical Oncology Society of Australia (COSA), physicians have been campaigning for exercise to become part of every cancer treatment plan.

“It makes a huge difference,” says Assoc Prof Lacey. “Doing any physical activity is better than none, but the gold standard is a personalised exercise prescription by a specialist exercise oncology expert.”

What’s particularly fascinating, she adds, is the opportunity to improve heart health by introducing exercise during treatment. Many cancer treatments, including chemotherapy and some targeted therapy drugs, can cause damage to the heart. Exercise can help repair and protect it.

“There’s now research showing that exercise during chemotherapy reduces this hit on the heart,” says Dr Kay.

Personalised care for cancer patients

When planning your exercise program as a cancer patient, it’s really important to remember the COSA guidelines are a generic overview and are quite broad, says Dr Kay.

“The key message in the guidelines is to ‘aim’ for this exercise when possible,” she says. “Even elite athletes have to change their training when the body is recovering.”

Assoc Prof Lacey believes each patient needs to work with a health expert to create a bespoke program targeted to their cancer and constantly modify it as they progress through their treatment.

“There’s a real need to have a skilled exercise physiologist or exercise specialist trained in oncology giving you a personalised program and not just saying ‘do 150 minutes of moderate exercise and two weight training sessions a week’,” she says. “You need to know what exercise is best for you at different times during your treatment and what’s going to give you the best outcomes.”

An expert in this field will be able to look at your situation to access the most appropriate options for you and your cancer treatment plan. This could include, for example, avoiding swimming pools if you’re immune-compromised or avoiding contact sports if you have cancer of the bone. They may also be able to suggest exercises that work with your lifestyle, home set-up and financial situation.    

Exercise and mental health

While cancer treatment can leave people feeling fatigued, with sleep problems or bone health issues, including exercise at the earliest stage of their cancer journey can improve both their physical and mental health, says Dr Kay.

“People say to us, ‘I want to be stronger – whether that’s mentally or physically’, and we can help with that,” she says.

Encouraging these feelings of power and strength is particularly important in patients who are experiencing an extreme lifestyle change following a cancer diagnosis or treatment.

“People always say to us, ‘I feel like this is the good part of my day – it’s something I can do, I can achieve’, because skilled exercise professionals know how to establish a pathway to improvement for them,” says Dr Kay.

Strength training is an important part as it’s the only type of intervention that can counteract the loss of muscle with treatment for all ages, she adds.

As obesity can increase the risk of cancer reoccurrence in some cases, Dr Kay suggests patients try to reduce this risk by focusing on exercise, diet changes and other lifestyle additions like yoga, qigong or tai chi. These mind-body activities have unique benefits for breathing, balance, mobility, sleep, mental health and the management of side effects.

“Making small changes in your diet and exercising can improve long-term outcomes,” she says. “Many of our patients are stronger, fitter and have better balance after cancer treatment than before diagnosis.”

This was true for Pauline, who felt exercise helped her feel strong through times when she was struggling and gave her a sense of autonomy over her situation.

“When everything else was completely out of my control, just in terms of treatment plans and doctor’s appointments, exercise was something I could do, something proactive I could be in charge of. It made me feel empowered and strong. Mentally that helped a lot,” she says. 

If you'd like some help to support your mental health through your cancer journey, eligible members can get a free annual HealthyMinds Check-in^ with a psychologist from PSYCH2U, with appointments available from early morning to late in the evening.

Finding the right support

For those looking for exercise guidance during their cancer journey, there are plenty of places to start, including speaking to your GP or specialist.

“The ideal scenario would be that every person going through cancer treatment has a package of exercise therapy that’s personalised and prescribed from the time of their diagnosis, because it improves outcomes,” says Assoc Prof Lacey.

Heading to hospital soon?

Going to hospital can be a source of anxiety. Our Preparing for hospital guide gives peace of mind with information and videos about common procedures. These resources can help you make informed decisions, ask the right questions, and find out what you need to know and do, before you head to hospital.